Common cases in cardiology: atrial fibrillation
This article describes the approach to the ward round in our third patient, Mrs Goodman, who has atrial fibrillation
- By: Krishan Patel, Lucie Weatherall, Rakesh Patel
Mrs Edith Goodman is an 86 year old woman who has been admitted to hospital with a three day history of feeling generally unwell and of having palpitations. She has been clerked by a nurse practitioner in the emergency department and has arrived at the cardiology ward just before the morning ward round. She is still waiting to be reviewed by a senior doctor. You review her notes before the ward round.
You skip to the last page of the clerking notes and see that there is a plan, made by the nurse practitioner, to treat for atrial fibrillation and probable dehydration with intravenous fluids and digoxin.
Atrial fibrillation is present in 5-10% of people over 65 years.1 It is the most common arrhythmia and is characterised by an irregularly irregular heart beat on examination. The need to treat atrial fibrillation needs to be verified by looking for supporting information